Individual
JERI H MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(765) 456-5900
Mailing address
10330 N MERIDIAN ST, INDIANAPOLIS, IN 46290-1024
(317) 319-7666
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
09/08/2010
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